S - Klotho, pro BNP, and Exercise Training in Coronary Artery Disease Patients - The 65th Annual Conference of the Israel Heart Society & The Israel Society of Cardiothoracic Surgery, 24-25 April 2018

Evgeny Radzishevsky Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel Liran Bradichansky Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel Alon Tanchilevitch Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel Ehud Goldhammer Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel Irit Maor Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel Uri Rosenschein Department of Cardiology, Bnai Zion Medical Center, Haifa, Israel MO Saghiv Department of Exercise Physiology, Harold C. Miller Center, University of Mary, Bismarck, USA

Background: S-Klotho, is a pleiotropic protein, acting as a co-receptor of the fibroblast growth factor 23 has been proposed as a key regulator of the development of cardiovascular disease (CVD). Brain natriuretic peptide (BNP) is a prognostic marker in patients with heart failure. S-Klotho and pro - BNP serum levels were assessed in order to find out whether exercise can modulate their activity.

Purpose: to assess the impact of 12 weeks exercise training program on S-Klotho and pro- BNP levels in CAD patients.

Methods: S-Klotho and pro-BNP serum were assessed in 2 groups: gr.A = 41 patients with recent coronary event were recruited to a 12 weeks supervised aerobic exercise program, gr. B, a control group, 17 CAD patients, who continued their usual treatment and lifestyle. Assessment was done prior and post exercise program. Serum s Klotho was analyzed using an α-klotho enzyme linked immunosorbent assay and the pro- BNP with an immunoassay method. Other baseline & post program parameters were assessed.

Results: No significant (p= 0.27) difference found between the two groups at baseline for S-Klotho, while a significant difference was found following exercise intervention, 863.39 pg/ml +/- 213.66 sd in gr. A compared to 677.71pg/ml +/- 167.46 sd in gr. B, p
BNP reduced significantly following exercise training, from 823.20pg.ml +/- 499.67sd to 84.90pg/ml +/- 349.26sd, p<0.05, whith no change in control group. S-Klotho and BNP showed an inverse correlation at baseline with similar values at end program. Klotho levels did not correlate with LVEF% or risk factors, Klotho levels continued improving in proportion to increasing METS values.

Conclusions: Aerobic exercise may modulate S-Klotho and Pro-BNP II activity, thus conferring a plausible explanation for the enhanced survival of CAD patients participating in an exercise based cardiac rehabilitation program.